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27-54-5
Section 27-54-5 Implementation of coverage. (a) A group health benefit plan, policy, or contract
that provides coverage for the services to be offered pursuant to this chapter may contain
provisions for maximum benefits and coinsurance and limitations, deductibles, exclusions,
and utilization review protocols to the extent that these provisions are not inconsistent
with the requirements of this chapter. (b) The issuer of a group health benefit plan, policy,
or contract may either disclose the additional premium for such additional mental health benefits
to the prospective contract holder and allow the contract holder to elect such additional
benefits on an optional basis; or conform its policies, contracts, or certificates issued
on and after January 1, 2001, and adjust its premium costs to reflect the additional benefit
costs. (Act 2000-386, p. 605, §6.)...
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27-19-38
Section 27-19-38 Coverage of newly born children in health insurance policies. (a) All individual
and group health insurance policies providing coverage on an expense-incurred basis and individual
and group service or indemnity type contracts issued by a nonprofit service corporation which
provide coverage for a family member of the insured or subscriber shall, as to such family
members' coverage, also provide that the health insurance benefits applicable for children
shall be payable with respect to a newly born child of the insured or subscriber from the
moment of birth. (b) The coverage for newly born children shall consist of coverage of injury
or sickness including the necessary care and treatment of medically diagnosed congenital defects
and birth abnormalities, but need not include benefits for routine well-baby care. (c) The
requirements of this section shall apply to all insurance policies and subscriber contracts
renewed, delivered, or issued for delivery in this state, 60...
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27-58-2
Section 27-58-2 Coverage for annual screening. On and after October 1, 2007, each health benefit
plan shall offer, together with identification of associated costs, policies and contracts
including coverage for the annual screening for the early detection of prostate cancer in
men over age 40. (Act 2007-389, p. 778, §2.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-58-2.htm - 628 bytes - Match Info - Similar pages
27-19-28
Section 27-19-28 Exclusion of hospitalization benefits for mental patients in tax-supported
institutions. (a) No policy of health, sickness, or accident insurance delivered, or issued
for delivery, in this state, including both individual and group policies, which provide coverage
for psychiatric treatment or mental illness shall exclude hospitalization benefits for mental
patients in tax-supported institutions of the State of Alabama, or any county or municipality
thereof. (b) The provisions of this section shall not apply to any policy of insurance in
effect prior to September 20, 1971, nor shall the provisions of this section apply to any
employee benefit plan providing hospital benefits for mental patients where such employee
benefit plan is established by the employer and contributions to the plan are provided by
the employer and the employee, or either of them, and such plan is not evidenced by individual,
or group or blanket policies of health, sickness, or accident insurance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-28.htm - 1K - Match Info - Similar pages
27-59-1
Section 27-59-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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36-30-50
Section 36-30-50 Supplemental insurance coverage for firefighters with cancer. (a) For the
purposes of this section, the following terms shall have the following meanings: (1) CANCER.
Includes bladder, blood, brain, breast, cervical, esophageal, intestinal, kidney, lymphatic,
lung, prostate, rectum, respiratory tract, skin, testicular, and thyroid cancer, leukemia,
multiple myeloma, Hodgkin's lymphoma, and non-Hodgkin's lymphoma. (2) CAREER FIREFIGHTER.
Any person employed with the state, a county or municipal government, an airport authority,
or a fire district who has obtained certification as a firefighter through and as defined
by the Alabama Firefighters' Personnel Standards and Education Commission, or a firefighter
employed by the Alabama Forestry Commission who has been certified by the State Forester as
having met the wild land firefighter training standard of the National Wildfire Coordinating
Group, and is offered typical employment benefits, including health insurance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-30-50.htm - 10K - Match Info - Similar pages
27-44-3
Section 27-44-3 Scope of chapter. (a) This chapter shall provide coverage for the policies
and contracts specified in subsection (b) as follows: (1) To persons who, regardless of where
they reside (except for non-resident certificate holders under group policies or contracts),
are the beneficiaries, assignees, or payees of the persons covered under subdivision (2).
(2) To persons who are owners of or certificate holders under the policies or contracts, other
than structured settlement annuities, and in each case who are either of the following: a.
Residents b. Not residents, but only under all of the following conditions: 1. The insurer
that issued the policies or contracts is domiciled in this state. 2. The states in which the
persons reside have associations similar to the association created by this chapter. 3. The
persons are not eligible for coverage by an association in any other state due to the fact
the insurer was not licensed in the state at the time specified in the state's...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-3.htm - 12K - Match Info - Similar pages
36-1-6.2
Section 36-1-6.2 Insurance coverage for state instrumentalities and agencies; prior contracts
and policies ratified. (a) Any instrumentality or agency of the State of Alabama, whose principal
activity consists of distributing goods or services by contract with the United States, or
any federal governmental corporation, and which are not covered by the provisions of Chapter
29 of this title, shall be subject to all the provisions of this section. Such instrumentality
or agency is hereby empowered to purchase and pay for group health, accident or hospitalization
insurance coverage for its officers and employees. Such instrumentality or agency is hereby
further authorized to contract with the State Employees' Insurance Board for group health,
accident or hospitalization insurance coverage, and under such terms, conditions, and costs
as the State Employees' Insurance Board and the instrumentality or agency shall mutually determine.
The cost or premium for such group health, accident or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-1-6.2.htm - 1K - Match Info - Similar pages
27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary,
and monthly report. (a) The commissioner may adopt regulations that include standards for
full and fair disclosure setting forth the manner, content, and required disclosures for the
sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions
of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting
conditions, termination of insurance, continuation or conversion, probationary periods, limitations,
exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions,
and definitions of terms. Regulations under this subsection should recognize the developing
and unique nature of long-term care insurance and the distinction between group and individual
long-term insurance policies. (b) No long-term care insurance policy may do any of the following:
(1) Be cancelled, nonrenewed, or otherwise...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-105.htm - 11K - Match Info - Similar pages
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